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Results for “Dermatologic Surgical Procedures”

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At least 19 recordsLinked to original sources
PubMed2001

Anxiolysis with oral midazolam in pediatric patients undergoing dermatologic surgical procedures.

BACKGROUND: Pediatric patients undergoing dermatologic surgical procedures often experience high levels of anxiety. Oral midazolam is a short-acting benzodiazepine that can ameliorate procedure-related anxiety. OBJECTIVE: Our purpose was to determine the safety and efficacy of oral midazolam as an adjuvant anxiolytic agent for pediatric patients undergoing dermatologic surgical procedures. METHODS: A prospective series of pediatric patients undergoing dermatologic surgical procedures who received oral midazolam were monitored, and efficacy and complications were recorded. RESULTS: Oral midazolam provided good to excellent anxiolytic effects in most pediatric patients undergoing painful dermatologic surgical procedures. Because midazolam does not provide analgesic effects, local anesthesia is necessary. Complications were uncommon and minor. CONCLUSION: Oral midazolam is an effective anxiolytic agent in pediatric patients undergoing dermatologic surgical procedures.

Administration, Oral↗
PubMed2000

The use of conscious sedation for outpatient dermatologic surgical procedures.

BACKGROUND: Dermatologic surgery has undergone increasing levels of sophistication over the past few decades. Commensurate with this demand, an established anesthesia technique called conscious sedation has been employed. OBJECTIVES: Methods for performing office-based conscious sedation are described. Recommendations are made regarding prerequisites for conscious sedation in an office setting, patient selection, complications management, and postoperative discharge requirements. CONCLUSION: The goals of anesthesia are to provide for patient safety and comfort, to increase patient acceptance of the procedure, and to enhance the surgeon's efficiency and satisfaction.

Ambulatory Surgical Procedures↗
PubMed1998

Closed dressings after laser skin resurfacing.

OBJECTIVE: To evaluate the safety, efficacy, and patient acceptance of closed dressings after full facial resurfacing with the carbon dioxide laser. DESIGN: Prospective cohort of men and women undergoing full facial carbon dioxide laser resurfacing. SETTING: Ambulatory surgical center at a university hospital. PATIENTS: Forty consecutive patients randomized to 1 of 4 dressing groups. INTERVENTIONS: All patients underwent full facial resurfacing with a carbon dioxide laser system. One of 5 closed dressings (single- or 3-layer composite foam, plastic mesh, hydrogel, or polymer film) was placed immediately after the procedure. Closed dressings were changed on postoperative day 2 and removed on postoperative day 4. OUTCOME MEASURES: Objective postoperative criteria of erythema, scarring, reepithelialization, and surface irregularities were recorded and photodocumented. Comparisons were made among the closed dressing groups as well as with a group of historical control subjects treated with open dressings. The ease of application, office time for preparation and application, and cost of the individual dressings were collected. Patient characteristics of overall acceptance, comfort, and ease of maintenance were recorded with a visual analog scale. RESULTS: There were no complications of scarring, surface irregularities, or contact dermatitis from the application or maintenance of the closed dressings. There were no significant differences in the number of days of postoperative erythema or in the rate of facial reepithelialization among the groups. Most patients preferred not to continue with the closed dressings past 2 days. Positive features from the use of closed dressings included reduction in crust formation, decreased pruritus, decreased erythema, and decreased postoperative pain, compared with historical controls. Negative features included time in preparation and application of the dressings. Costs ranged from $9.79 to $50 per dressing change. CONCLUSIONS: Closed dressings are safe and offer benefits noted during the first 4 postoperative days. Patients can be expected to maintain a closed dressing for at least 24 hours but no longer than 4 days. The positive features of closed dressings and patient acceptance outweigh the cost and office time involved with their application and maintenance.

Adult↗
PubMed1976

Rehabilitation problems of head and neck cancer patients.

Head and neck cancer and its treatment result in varying degrees of disability affecting various organ systems. Ideal treatment of such patients requires a unit capable of managing problems in the areas of: Reconstructive surgery, maxillofacial prosthodontia, dentistry, deglutition disorders, and psychological, social, and vocational rehabilitation. Provision of such facilities in an integrated manner will give the patient the optimal chance for rehabilitation from the complex disabilities occurring in head and neck cancer.

Carcinoma, Squamous Cell↗
PubMed1992

Percutaneous release of the trigger finger: an office procedure.

A new technique for percutaneous release of the trigger finger is described. A 21-gauge hypodermic needle is used to release the A1 pulley. The technique is effective, convenient, safe, and well tolerated by patients. Thirty-three of 35 procedures (94%) led to complete relief of symptoms, and in the remaining two digits partial symptomatic relief was achieved. There were no significant complications. After a mean follow-up of 13 months, there had been no recurrences. This technique should be the treatment of choice for the established trigger finger with symptoms of more than 4 months' duration.

Adult↗
PubMed1994

Effects of surgical stimulation on midlatency auditory evoked potentials during general anaesthesia with propofol/fentanyl, isoflurane/fentanyl and flunitrazepam/fentanyl.

During general anaesthesia, midlatency auditory evoked potentials are suppressed in a dose dependent manner by a number of general anaesthetics. The activating effects of surgical stimuli on midlatency auditory evoked potentials have been demonstrated during light inhalational anaesthesia, and indicate that midlatency auditory evoked potentials reflect the activity of the central nervous system and not only anaesthetic concentrations. We investigated the effect of surgical stimulation (skin incision, sternotomy) on midlatency auditory evoked potentials under high dose opioid analgesia in 30 patients undergoing elective cardiac surgery. High dose opioid analgesia was maintained using fentanyl (1.2 mg.h-1) and combined with either propofol (4-8 mg.kg-1.h-1) (group I, n = 10), isoflurane (0.6-1.2 vol%) (group II, n = 10) or flunitrazepam (1.2 mg.h-1) (group III, n = 10). Midlatency auditory evoked potentials were recorded in the awake state, during general anaesthesia before skin incision, after skin incision and after sternotomy. During general anaesthesia there were marked statistically significant increases in latencies and decreases in amplitudes of midlatency auditory evoked potentials in the propofol/fentanyl and isoflurane/fentanyl groups. In contrast, in the flunitrazepam/fentanyl group there were only small changes of midlatency auditory evoked potentials. The latencies of the early cortical potentials were similar to those in the awake state. After skin incision as well as after sternotomy no significant changes of midlatency auditory evoked potentials could be observed in any of the experimental groups. These results indicate that activation of the auditory pathway by surgical stimuli may be blocked when analgesia is provided by high dose fentanyl.(ABSTRACT TRUNCATED AT 250 WORDS)

Anesthesia, General↗
PubMed1988

Sterile technique and the prevention of wound infection in office surgery--Part I.

Surgical infection and associated complications are minimized by a combination of appropriate sterile technique and careful surgical technique. This review covers the essential elements of infection control for the office-based surgical practice. Recommendations are made concerning operating room facilities, instrument sterilization, and tray setup (Part I). Part II addresses surgical prepping, surgical technique, and prophylactic antibiotics.

Ambulatory Surgical Procedures↗
PubMed1990

[Delayed midsternal wound reconstruction for infants without secondary sternal closure].

Three infants, aged 11 days, 19 days and 48 days, underwent two Jatene operations and one modified Norwood operation. The sternum was left open and the skin defect was covered with a silicon sheet in all three patients. Delayed sternal closure was impossible because of hemodynamic deterioration in all three patients. Consequently delayed midsternal wound reconstruction was applied. One rectus abdominis muscle flap was turned up and the defect between the split sternum was filled with this muscle flap. Bilateral axillary incision was made to decrease the skin tension and the midsternal wound was closed with cutaneous advancement flaps. Bilateral axillary defects were covered with mesh skin implantation. All three patients recovered after this procedure. We propose this technique for the cases in which the delayed sternal closure is impossible.

Abdominal Muscles↗
PubMed1988

Can stitches get wet?

This study was performed to answer the question of whether or not a patient can wet stitches after a minor soft-tissue surgical procedure without increasing the incidence of infection or disruption of the wound. One hundred consecutive patients underwent an excision of a skin or soft-tissue lesion closed either primarily or with a local flap. Monofilament nylon was used. There were 55 benign lesions and 45 malignant lesions. All procedures were performed using local anesthesia on an ambulatory basis. All patients were asked to wash the wounds with soap and water twice a day starting the morning after surgery. All wounds healed without any infections and without any disruption or dehiscence of the wounds.

Adolescent↗
PubMed1985

High frequency needle dissection rhytidectomy.

Fifty consecutive rhytidectomies were performed utilizing high frequency needle dissection on one side and standard sharp dissection on the other for all incisions and flap elevation. The efficacy of this technique in hemostasis, prevention of hematoma, and wound healing is compared to the conventional technique of rhytidectomy. The advantages and disadvantages of the modality are discussed.

Ambulatory Surgical Procedures↗
PubMed1994

A safe percutaneous procedure for trigger finger release.

A safe and easily performed method for percutaneous release of trigger digits is described which is performed in the outpatient clinic within a few minutes, without requiring any special instrument. Results in terms of abolishing triggering immediately and patient acceptance are excellent. No important complications have been observed in our first 38 procedures.

Ambulatory Surgical Procedures↗
PubMed2005

Antibiotic prophylaxis in dermatologic surgery: updated guidelines.

BACKGROUND: Antibiotic prophylaxis in dermatologic surgery is poorly understood, and data on its use are lacking. Prophylaxis is indicated for the prevention of endocarditis and prosthesis infection, as well as surgical site infection. OBJECTIVE: We review essential considerations for the use of antibiotic prophylaxis in dermatologic surgery and provide clear guidelines for practical implementation. METHODS: Guidelines were developed after review of the literature and consultation with infectious disease specialists and subspecialists in the areas of cardiac, orthopedic, and neurosurgical infectious disease at Mayo Clinic. RESULTS: Three factors affect the decision to use prophylactic antibiotics in dermatologic surgery: (1) the underlying indication for prophylaxis (patient risk stratification), (2) the condition of the skin, and (3) the specific procedure planned. Thorough preoperative evaluation and surgical planning are critical in identifying and optimizing patient and environmental risk factors that may increase the risk of infection. Appropriate antibiotic selections with site-specific consideration and appropriate timing of antibiotic administration are key factors in providing effective prophylaxis. CONCLUSIONS: Low rates of infection associated with dermatologic surgical procedures warrant selective use of antibiotic prophylaxis. The proposed guidelines reflect current standards of practice.

Antibiotic Prophylaxis↗
PubMed1995

Dermatologists and antibiotic prophylaxis: a survey.

BACKGROUND: Antibiotic prophylaxis is frequently used for the prevention of infection at a distant site such as the heart valve or prosthetic joint. However, there are no published data describing how dermatologists manage patients "at risk". OBJECTIVE: The purpose of this study is to document prophylactic antibiotic use by dermatologists. METHODS: A total of 211 randomly selected community dermatologists and 69 academic dermatologic surgeons were surveyed by questionnaire to determine whether they would provide antibiotic prophylaxis in 20 different clinical situations. RESULTS: This survey showed that under certain circumstances, almost all dermatologists provide antibiotic prophylaxis to prevent infection at a distant site. However, many dermatologists use antibiotics in settings with relatively little or no indication and confuse a prophylactic regimen with treatment of a superficial infection. CONCLUSION: This survey underscores the need for education and research into the prophylactic management of patients "at risk" who undergo dermatologic surgical procedures.

Academic Medical Centers↗